Cynthia M. Rand, M.D., M.P.H., from the University of Rochester in New York, and colleagues examined the impact of QI training plus a bundled practice-based intervention on improving HPV vaccinations in pediatric resident continuity clinics. Staff and providers from eight resident clinics participated in the 12-month study. The intervention comprised training to strengthen provider communication relating to the HPV vaccine, as well as provider prompts, monthly performance feedback, and collaborative-calls training. The primary outcome measure was captured HPV vaccination opportunities (eligible visits with vaccination divided by vaccine-eligible visits).

The researchers observed an increase in captured opportunities for HPV vaccination, from 46.9 to 63.3 percent. Centerline shift demonstrated special cause, with eight consecutive points above the preintervention mean. Patients were more likely to receive a vaccine during the intervention compared with before the intervention, on adjusted analyses (odds ratio, 1.87). At both well-child and other visits there were improvements in captured HPV vaccination rates (by 11.7 and 13 percentage points, respectively).